HOW TO

LOSE WEIGHT
PERMANENTLY
 TABLE OF
CONTENTS

Chapter 1
HOW I BECAME A WEIGHT LOSS EXPERT

Chapter 2
REASON #1 - OVERDESIRE

Chapter 3
REASON #2 - OVERHUNGER

Chapter 4
REASON #3 - EMOTIONAL EATING

Chapter 5
YOU CAN PERMANENTLY LOSE THE WEIGHT TOO!
 1
CHAPTER
HOW I BECAME A
WEIGHT LOSS EXPERT

As an overweight physician, I had many emotions

about the fact that I couldn’t get my weight under
control. I felt ashamed, embarrassed, frustrated,
and sorry for myself.

No weight loss experts understood what my life

as a busy doctor and mother was like. They all
suggested solutions that would never work in my
circumstances. There was no way I could eat a
small meal every couple hours in the middle of my
BEFORE
jam-packed clinic. And who had time to prepare
all those meals anyway? Choking down gross-
tasting shakes was not a good long-term solution.
I knew that weight loss medications or bariatric
surgery were not the solution for me either.

I became a lifetime member of Weight Watchers

right before residency started but could never
keep the weight off. I lost and gained back 40 lbs
over and over again. Every time I lost it, I would
promise myself that this was the last time and
AFTER
that I was never going to let myself regain it back.
Until the next time I went out of town or on
vacation. Then I was right back into gaining mode.
The stress of clinical practice didn’t help either. I’m a pediatrician and worked
for over ten years in a very successful and very busy private practice. I would
bring the healthy lunch I packed for myself but as soon as I smelled the
delicious food brought in by a drug rep, I would tell myself I could save my
lunch from home for the next day. Seemed like a win-win because lunch for
tomorrow was already made!

And then I’d overeat. My favorites were salty tortilla chips, brownies, and
cookies. It didn’t matter if I was hungry or not -- if those were around, I would
definitely eat them. When I’d feel particularly stressed out and had a free
moment, I’d head back to the lunchroom to see if there was anything else
laying around that could be a little treat or reward for me. And at the end of
clinic, when I was hungry for dinner but knew I had many charts to finish and
phone calls to make before I could leave, I’d fill a bowl with the animal crackers
we kept in the office as a snack for the patients. I’d munch and work, work
and munch. It became a bit of a ritual that helped me feel better about how
exhausted and stressed I felt and about missing dinnertime with my kids.

As I approached my fortieth birthday, I started reevaluating many areas of my

life. My weight was one of those areas. I was done having children and had
once again regained the baby weight I had lost after delivering my daughter. I
had more evidence than ever that I couldn’t lose weight and keep it off. I knew
that I had to do something different. Maybe even something drastic.

I discovered and decided to hire a life coach who helped women lose weight.
She said she could help me keep the weight off forever. It was a huge leap
of faith and a huge investment, but I hired her and promised myself (and my
husband!) that I would do everything she told me to do.

It was through this process that I finally cracked the code to my weight
problem. I had never thought that I was an emotional eater but it turned out
I was! I just thought I liked food and that it was as simple as that. I lost 55
pounds and have kept it off.
Once I got these incredible results for myself, I knew I had to share with my
fellow women physicians who were also struggling with their weight. I became
obsessed with life coaching and became a certified life and weight loss coach
myself. I even left my medical practice to focus on helping women physicians
lose weight and keep it off permanently.

What I have found is that there are three factors at play when it comes to
weight loss and weight gain. In the following pages of this book, I’m going to
share with you what I discovered. Let’s dive right in.

THERE ARE THREE REASONS YOU HAVEN’T

SUCCESSFULLY LOST WEIGHT YET.

OVERDESIRE
We allow the pleasure-loving primitive part of our brain to determine
our decisions, instead of our prefrontal cortex which helps us to make
rational choices.


OVERHUNGER
We fuel our bodies in a way that human bodies were never designed
to be fueled. We snack or eat mini meals which keeps our insulin levels
chronically elevated. When this happens, our bodies rarely have the
chance to access the fat stores we have on our bodies. We feel hungry
too often and the hunger feels very uncomfortable, as though it were an
emergency!

EMOTIONAL EATING
We don’t view food as fuel. Instead, we eat when we’re happy and when
we’re sad. We drown our sorrows with food. We entertain ourselves with
food. We find companionship with food. We celebrate life’s big moments
with food. Birthday cake, anyone?
The good news is that you can lose the weight you’re looking to shed and
you can keep it off permanently. You just need to know why you’re not losing
weight. Once you know “the why,” you can work on “the how” to create long
lasting change.
 2
CHAPTER
REASON #1
WHY YOU HAVEN’T LOST THE WEIGHT YET

OVERDESIRE

To really understand overdesire, we first have to understand how our brains

work. Greatly simplified, there are two parts of the brain involved in decision-
making: the limbic system and the prefrontal cortex.

Our limbic system is very primitive. It was the first part of the human brain
that evolved and its job is to keep us alive.

It is motivated by three main things:

AVOIDING SEEKING EXERTING AS LITTLE

PAIN PLEASURE EFFORT AS POSSIBLE

The primitive part of the brain is truly focused on these three things and
really doesn’t care about anything else. I like to compare it to a toddler with
a knife. Toddlers are cute, sweet, and really do mean well. But without proper
supervision, a toddler with a knife can do some serious damage.

The prefrontal cortex is more complex; it’s the part of the brain that makes
us human. It allows us to think rationally and to think about what we’re
thinking about. It’s able to weigh the pros and cons of a situation, taking into
account what we’ll want in the future as well. The prefrontal cortex is like the
supervising mother of the toddler with a knife.
The mother of a toddler utilizes rational thinking from her prefrontal cortex to
provide boundaries and supervision which protects the child from danger. She
says to the toddler, “Hey buddy, I know you really want to play with that knife
and it looks so fun, but it’s got a sharp edge that can really hurt you. I’m going
to take this from you because it’s my job to help keep you safe. You can cry all
you want, but I still am not going to give it to you.”

Eating food provides humans with pleasure. When we eat food that is fuel for
the body, the brain releases dopamine which lights up the reward center in the
brain and makes us feel good. It makes sense that eating food is pleasurable,
since without it, we would starve to death. The primitive brain is programmed
to take note of a pleasurable experience so that it can encourage us to repeat
that action and therefore experience pleasure again. The way it encourages us
is by creating desire for fuel food.

Up until a few hundred

years ago, this was how
humans consumed
Eat fuel food food. Then we figured
out how to increase the
pleasure in our food by
concentrating it. The
Desire for fuel two main concentrated
Small dopamine
food release forms of pleasure
that we created are
sugar and flour. Food
manufacturers take
Small amount of
pleasure whole foods and
process them down
into substances that
provide us with much
more intense pleasure than we get when we consume the same foods in their
natural form. The primitive brain is just doing its job when it takes note of that
huge amount of pleasure and creates a huge amount of desire to repeat it.
That’s why it’s so hard to say no to the brownie that the drug rep brought in.

When we decide to go on a diet to lose weight, we still experience this high

amount of desire. But instead of acting on it and eating the brownie, we use
willpower to make a different decision and avoid eating it. The problem is that
willpower is like a muscle - it fatigues. Research shows that we are not able to
keep willpower up indefinitely. So once the willpower weakens (often in the
evening after a long day of resisting the desire), we give in and meet the urge
to eat the foods we have such overdesire for. That puts us right back into the
cycle of the primitive brain overemphasizing the importance of these foods
and creating too much desire for them.

This can feel like a never-ending cycle and makes our experience of losing
weight quite miserable.

Eat concentrated
Willpower
sugar and flour
fatigues

Give in and eat HUGE dopamine

more release

Use willpower
to resist

Immense desire
(cravings and urges)
for more sugar LOTS of
and flour pleasure
The Solution: REDUCE OVERDESIRE FOR FOOD.

The best way to reduce overdesire for food is to stop eating flour and sugar.
When primitive brain-driven urges to eat flour and sugar are not met, the brain
stops creating the urges. This is neuroplasticity at its finest. Just like consuming
flour and sugar helped create the neural connections that drive the overdesire,
not consuming flour and sugar will allow those connections to dissolve.

Another great way to reduce overdesire is to make decisions ahead of time.

When you plan the food you’ll eat in advance, it’s easy to know what to eat
in the moment -- only what you preplanned. Since you already made all the
decisions with your prefrontal cortex, you know you can trust your plan.
When you make decisions in the moment, the primitive brain takes over with
justifications and will surely convince you that you’ve been eating so well lately
that a piece of cake won’t make a difference.

It’s important to stay aware of these urges from the primitive brain and
approach them with patience and compassion. Nothing is going wrong when
your brain offers you foods that are not on your plan. Understanding that the
urges are just unintentional programming in the brain can help you be patient
while new neural pathways are being built and reinforced.

Check out these additional podcast episodes on the topic of overdesire:

PODCAST EPISODE #3:

Choosing an Action Plan for Weight Loss

PODCAST EPISODE #8:

Making Decisions Ahead of Time
 3
CHAPTER
REASON #2
WHY YOU HAVEN’T LOST THE WEIGHT YET

OVERHUNGER

When you’re consuming flour and sugar on a regular basis, which most people
are since it’s hidden in just about every processed food, your sensations of
hunger are very, very intense. Some people describe it as though their stomach
is “eating itself” or they’re just “hangry,” which is the combination of hungry
and angry. Or they feel like finding food to make the hunger go away is an
emergency. “Everybody get out of the way. I need food immediately. I can’t
even deal with this!” Others experience significant lightheadedness or even
worry they might faint.

“Suger Burner”
The body prefers easily
digestible sources of
The term that I use to
describe somebody whose
body functions in this way
is a “sugar burner.” What
that means is that your body

energy (sugar and flour). prefers to make you feel

physically pretty terrible so
that you’ll eat some easily
digestible forms of energy like sugar and flour. It would much rather utilize
those foods for your energy than actually access your fat stores and turn the
fat into energy.

I used to wonder to myself, “How is it possible for me to be so intensely hungry

when I have multiple pounds of extra fat on my body? Seriously, can my body
not just access the fat on my stomach or my butt? After all, that’s what they’re
there for!” When you’re a sugar burner, your body will resist converting your fat
to energy because it’s so accustomed to being fed the majority of the energy it
needs (and then some!) to keep you alive.

When you’re hungry all the time, or very frequently, you end up eating all the
time. Eating food stimulates your pancreas to secrete insulin, and insulin is a fat
storage hormone. Insulin takes the glucose out of your bloodstream and puts it
into your cells for energy. It then stores the extra as glycogen in your liver, and
anything that’s still left over is stored as fat in your fat cells. If you’re eating on
a frequent basis, such as snacking, eating mini-meals every few hours, sipping
on anything that’s caloric throughout the day (hello pumpkin spice lattes!),
nibbling on little bites, tastes, and licks here and there, what you’re doing is
keeping your insulin levels chronically elevated. When that happens, you’re
almost always in fat storage mode.

If you’re someone who gets up and immediately starts consuming something

and then consumes throughout the day all the way up until your bedtime
snack, then the only time that you’re allowing your body to use your fat stores
for energy is when you’re sleeping. Most of us aren’t getting enough sleep as it
is, so there’s maybe six or seven hours a day or less where our bodies are given
access to those fat stores. Knowing all of this information, it makes sense why
so many of us have not been losing weight very easily.

The Solution: GLUCONEOGENESIS

The solution to overhunger is gluconeogenesis, which luckily our

bodies innately know how to do -- they just need to be coaxed to do it.
Gluconeogenesis is when our bodies break down our body fat and convert that
fat back to glucose for our cells to use for energy. The best way to do this is to
become fat adapted.

When you’re fat adapted, your body willingly and happily utilizes
gluconeogenesis to create energy from your fat stores. When you feel a hunger
pang, it doesn’t feel very intense or like a big deal at all. It feels very tolerable.
When you start feeling a little bit of hunger, it really feels like just a suggestion
to eat something. It’s not like you’re being pounded over the head, like the
you-need-to-eat-now kind of hunger. You could eat if it’s convenient, but if not,
it’s really no big deal. It feels like a little wave that comes and just as easily goes
away. Your body very happily accesses your fat stores for energy instead. This
is how our bodies were designed to optimally function.

So many of us think that we’re broken because we haven’t been able to lose
weight and keep it off. Luckily, all of us were born with the ability to perform
gluconeogenesis. We just have to remind our bodies how to do it.

Another way to allow gluconeogenesis is to stop snacking. When you’re

snacking, which so many of us do, you’re always going to be in storage mode.
Unfortunately, we’ve been trained by nutritionists and other experts to eat little
mini-meals and snacks throughout the day. When you eat this way, you’re not
accessing those fat stores.

Tweaking your meals so that you get enough foods that satiate you will help
you to make it to the next meal without needing a snack. In between meals,
your body can just access those fat stores for you. It’s no problem at all.

Intermittent fasting is another tool you might consider utilizing to allow your
body to fuel itself with one of the many meals it is already storing (in your fat
cells). Intermittent fasting is not starvation and once you’re fat adapted, it’s
very easy and comfortable.

As I’ve worked with my clients, I’ve found that most physicians love this tool.
There are already so many times when they have to miss a meal because of
their tight schedule, patient care demands, or some sort of emergency. When
this happens, they grab a glass of water and carry on with their day. Missing a
meal is no longer an issue for them. They know their body has fat reserves to
tap into and they have a nice filling meal at their next mealtime. It’s definitely a
win-win situation.
Check out the following resources I have on the topic of overhunger:

PODCAST EPISODE #6:

Building Awareness of Your Eating Habits & The Hunger Scale

PODCAST EPISODE #66:

Getting Up Close and Personal with Hunger

PODCAST EPISODE #50:

How to Learn From Failures And Break The Overeating Cycle
 4
CHAPTER
REASON #3
WHY YOU HAVEN’T LOST THE WEIGHT YET

EMOTIONAL EATING

Emotional eating is defined as eating for any reason other than to fuel
your body.

There are countless reasons why we eat that have nothing to do with fueling
our bodies. We entertain ourselves with food when we’re bored. Food is our
trusty companion when we’re lonely. We cheer ourselves up with food when
we’re sad. We eat to take the edge off our stress at the end of a busy week.

But we don’t stop there. We eat extra food when we experience positive
emotions too. We celebrate birthdays and anniversaries with a nice meal and
a favorite dessert. We connect with friends by meeting for dinner and drinks.
We reward ourselves with a special treat when we accomplish something. And
sometimes that accomplishment is just having gotten through the day! There
really are endless ways we eat emotionally.

I’ve had many clients tell me at first that they really didn’t think they were
emotional eaters. They thought they just liked food! I understand because I
used to have very similar thoughts about myself. I envisioned an emotional
eater as someone who had a difficult time functioning at a high level in their
life and was constantly eating to try to feel better. I didn’t identify with this and
my clients don’t either. But if you ever eat food for any other reason than true
physical hunger, you are an emotional eater.

The Solution: STOP EMOTIONAL EATING BY LEARNING TO

PROCESS YOUR EMOTIONS.
The solution to emotional eating is to learn how to feel your feelings. It’s
important to understand that emotions are simply the result of a chemical
cascade that occurs after two neurons fire together in the brain. This neuronal
connection is what happens when we have any thought. Humans have
anywhere from 40,000 to 60,000 thoughts every day, so we are constantly
experiencing some sort of emotion.

To feel better, we don’t need to eat. We need to manage

our thinking. The best way to process emotions is with
the thought model. In the model, the circumstance
includes only the neutral facts about a situation. We have
thoughts about the circumstance and those thoughts
generate our feelings. Our feelings drive our actions and
our actions create our results. Our results are always
proof or evidence of the original thought.

The thought model can be used to uncover what the thoughts are that are
creating the unwanted emotions and results that you’re currently experiencing.
Then it can be used to create the results that you want. The following examples
show the original model as well as the new, intentional model that can help you
create the results you want.

ORIGINAL MODEL: INTENTIONAL MODEL:

C The scale reads 200 lbs C The scale reads 200 lbs

T I can’t believe I let it get this bad T I’m going to make a change

F Disgusted, disappointed F Determined, motivated

A Beat myself up, eat comfort food 

A Stop eating flour and sugar,
follow eating plan

R Gain a pound, let it get worse 

R Lose a pound, make permanent
changes
When you find yourself thinking your original thought, you gently and
deliberately think your new thought instead. With practice, your default way of
thinking will switch from the original model to the new, intentional model. This
is how you create any new result you want in your life.

Check out the following resources to learn more about emotional eating:

PODCAST EPISODE #2:

Practicing Awareness of Your Thoughts and Feelings

PODCAST EPISODE #54:

Buffering Positive Emotions

ARTICLE:
Are You an Emotional Eater?
 5
CHAPTER
YOU CAN PERMANENTLY
LOSE THE WEIGHT TOO

Here’s the best news I have for you: Lasting, sustainable weight loss can be
achieved. While it’s important to eat in a way that allows your body to function
the way it was designed to, we must recognize that so much of our experience
of losing weight and keeping it

Lasting, sustainable off has to do with our thinking.

As a certified life coach, I have led
weight loss can hundreds of physicians through the
process of losing the weight as well
be achieved. as creating freedom around food.

Time and again, my clients share with me that reaching their goal weight and
keeping it off for good was amazing, but not the best part of working with me.
They tell me that the best part is that by learning to change their thinking, they
now have the life they always wanted. Their relationships are better, they’re
enjoying their work as a physician again, and they experience so much less
stress, at work and at home. They couldn’t be happier or more satisfied.

If you’re a woman physician in clinical practice who wants similar results, I have
great news for you. I created my Weight Loss for Doctors Only group coaching
program exclusively for you. To learn more about my next coaching group,
click here.
In the meantime, check out my wildly popular podcast, Weight Loss for Busy
Physicians. Each week, I publish a great new episode on topics related to
weight loss. Click here to learn more or search for the Weight Loss For Busy
Physicians podcast on your favorite podcast listening app and click ‘Subscribe”
so that you never miss an episode.

W W W. KAT R I N AU B E L L M D.CO M